Sauerwein H P, Pesola G R, Groeger J S, Jeevanandam M, Brennan M F
Surgical Metabolism Laboratory, Memorial Sloan-Kettering Cancer Center, New York.
Metabolism. 1988 Nov;37(11):1045-50. doi: 10.1016/0026-0495(88)90065-0.
Glucose oxidation is inhibited in severely ill patients. The present investigation was designed to study the relationship between glucose tissue uptake, glucose oxidation, and FFA concentration in septic cancer-bearing patients. The influence of glucose infusion alone (3.9 mg x kg-1 x min-1), followed by a euglycemic clamp with the same glucose load, on oxidation of glucose, plasma FFA concentration, and lipid oxidation were measured in eight septic cancer-bearing patients. During infusion of 3.9 mg glucose x kg-1 x min-1 glucose tissue uptake was 4.6 +/- 0.3 mg x kg-1 x min-1, glucose oxidation 0.5 +/- 0.2 mg x kg-1 x min-1, FFA concentration 377 +/- 52 mumol x L-1, and lipid oxidation 2.0 +/- 0.2 mumol x kg-1 x min-1. During the euglycemic clamp glucose tissue uptake was 4.4 +/- 0.3 mg x kg-1 x min-1, glucose oxidation rose to 1.8 mg x kg-1 x min-1 (.001 less than P less than .01), FFA concentration dropped to 202 +/- 23 mumol x L-1 (P less than .001), and lipid oxidation to 1.2 +/- 0.2 mumol x kg-1 x min-1 (.001 less than P less than .01). Nonprotein respiratory quotient rose from 0.73 +/- 0.02 to 0.85 +/- 0.02 (.001 less than P less than .01); 11% +/- 5% of the total amount of glucose taken up by the tissues was oxidized during infusion of glucose alone and increased to 42% +/- 6% during the euglycemic glucose clamp. It is concluded that in septic cancer-bearing patients glucose oxidation is inhibited during infusion of 3.9 mg glucose x kg-1 x min-1, even when expressed as percentage of glucose tissue uptake. With insulin, glucose tissue uptake was not influenced, but glucose oxidation expressed as percentage of glucose tissue uptake was normalized.
重症患者的葡萄糖氧化受到抑制。本研究旨在探讨脓毒症癌症患者葡萄糖组织摄取、葡萄糖氧化与游离脂肪酸（FFA）浓度之间的关系。对8例脓毒症癌症患者测量了单独输注葡萄糖（3.9mg·kg⁻¹·min⁻¹），随后以相同葡萄糖负荷进行正常血糖钳夹时，葡萄糖氧化、血浆FFA浓度和脂质氧化的影响。在输注3.9mg葡萄糖·kg⁻¹·min⁻¹期间，葡萄糖组织摄取为4.6±0.3mg·kg⁻¹·min⁻¹，葡萄糖氧化为0.5±0.2mg·kg⁻¹·min⁻¹，FFA浓度为377±52μmol·L⁻¹，脂质氧化为2.0±0.2μmol·kg⁻¹·min⁻¹。在正常血糖钳夹期间，葡萄糖组织摄取为4.4±0.3mg·kg⁻¹·min⁻¹，葡萄糖氧化升至1.8mg·kg⁻¹·min⁻¹（0.001＜P＜0.01），FFA浓度降至202±23μmol·L⁻¹（P＜0.001），脂质氧化降至1.2±0.2μmol·kg⁻¹·min⁻¹（0.001＜P＜0.01）。非蛋白呼吸商从0.73±0.02升至0.85±0.02（0.001＜P＜0.01）；在单独输注葡萄糖期间，组织摄取的葡萄糖总量的11%±5%被氧化，而在正常血糖葡萄糖钳夹期间增加到42%±6%。得出结论，在脓毒症癌症患者中，即使以葡萄糖组织摄取的百分比表示，在输注3.9mg葡萄糖·kg⁻¹·min⁻¹期间葡萄糖氧化也受到抑制。使用胰岛素后，葡萄糖组织摄取未受影响，但以葡萄糖组织摄取的百分比表示的葡萄糖氧化恢复正常。
